Goodbye, dear friend

I am a geriatric nurse, As some of you may know. I have worked in a number of long-term care facilities over the course of my 17-year career and while it's not the sexiest type of nursing ever, it's one I feel called to, even though I have enjoyed other types of nursing.

One of the joys of working in LTC is the relationships that we form with the residents. Over the course of admission, we see so many changes in our residents. We cheer them on when they attain therapy or other goals and we comfort their pain, whether physical or psychological. Some of our residents are with us for long periods of time. Maybe it's just me, but I feel it's impossible to work in a facility for any length of time and not form attachments to residents. It's the hallmark of what we do.

One aspect of working in LTC is the fact that we see a fair amount of death. Sometimes a resident will slowly decline over a substantial amount of time and sometimes it occurs so suddenly that it takes our breath away. I have been to this rodeo more times than I can count during my career and know there's more to come. Still, I come away from the experience feeling some degree of loss, more often than not.

Let me frank here - the death of a well-loved resident is tough. A nurse can't expect to work in a LTC facility and not be affected by the passing of someone they have spent many hours caring for; it's just not a realistic expectation.

Tonight I am anticipating the passing of a resident that I have grown close to in the short time that I have been at this facility. There's not much left to do but keep her comfortable and pain-free. I won't lie - this one's going to be hard. As I have been caring for her tonight, several thoughts have come to mind about caring for someone dying and I wanted to share them here.

1) Keep the family in the loop.

If there are family members at the resident's bedside, greet them early in the shift and let them know you are there for them as well the resident. It also helps to tell them how long you will be there and what they can expect of you. Ask if they need anything and if they do, get it for them. Be available to them. Family members will often have questions about the process and by answering them you increase their comfort level. If family members are staying with their loved one, make them as comfortable as you can by offering food, drink and bedding. I take a holistic approach in caring for my residents as they enter this last stage of life and part of that is taking care of their families, too. Give families someone to trust and rely on during a difficult time. 

2) Let the family reminisce with you.

I wish I could count the number of times over the years that family members have shared with me special stories about my residents. It's yet another connection that can be so important to a family (and to caregivers!). They want us to know what their loved one was like before illness, that they were special and important.

3) Be like Tom Bodett and keep a light on.

This is especially important if the resident is alone. The light shouldn't be bright, but enough that the resident is not feeling that they are alone and isolated. No one should be left alone in the dark. 

4) Talk to the resident.

We're told that hearing is one of the last senses to leave. Whether or not the resident is capable of talking with you, tell them what you're doing, that you're there, and above all, that they're not alone. This can even be just simply chatting about the things you enjoyed talking with the resident about.

5) Keep the resident comfortable. 

Keep the room warm. It might be too warm for you, but at some point in the dying process thermoregulation declines and even though they feel warm to you, they might not actually be feeling that warmth. Keep the resident's skin clean and dry and keep their mouth clean and moist. 

6) Don't be afraid to show emotion.

As I mentioned earlier, one of the joys of taking care of long-term residents is the relationships we build with them but this can be a double-edged sword then they die. We don't have to be a family member to experience loss when someone we've cared for passes away. We've seen our folks through a lot of life changes and we've forged bonds with them through our shared experiences as residents and caregivers, so it stands to reason that the end of that relationship is can be cause for grief. Let that grief out. Don't be afraid to share your feelings with your co-workers. Chances are that they are feeling the same and talking with them can be great support for everyone involved. 

Above all else, treat the resident as you would want a parent or child, or yourself, treated under the same circumstance.

I am no expert here, but these are things I've observed over the years I've been practicing. They have been at the forefront of my thoughts the last few days and I wanted to share them. I've talked to some folks over the years who ask, "How can you do that?" My answer? Someone has to and I'm glad it's me.

Blah.....

I wasn't going to write today. I couldn't think of a good topic, and have been in such a pissy mood that I didn't think anyone would really appreciate my whining, but now I have to crow a little bit.

I walked a mile.

It took a turtle-like 42 minutes, but I did it and actually worked up a sweat. Woohoo, I burned off a whole cookie!

Sticks and stones.....

Today a family in Illinois is grieving the loss of a 10-year-old daughter. The young girl took her own life in response to pain that no one listened to. Why?

She was bullied.

According to the Chicago Tribune, Ashlynn Conner, a fifth-grader, had been teased by other kids who called her "fat" and "ugly" and after a recent haircut, "a boy". Ashlynn was found by her 14-year-old sister just half an hour after family members had overheard Ashlynn talking about the bullying on the phone with a friend.

I can't understand this. My mind just can't wrap itself around the fact that, even though Ashlynn and her parents made school authorities aware of what was going on, those same authorities failed her. Have failed others. Will fail again. Bullying happened when I was a kid in the 70's, it happened before then, it's happening now.

And it won't stop until those adults charged with the responsibility of keeping our children safe, wherever they are, ditch the "kids are kids" excuse and start taking action. It's not just a scratch on the playground - kids are dying out there and it's up to the grownups to take a stand to protect them. Kids look to us adults as protectors and role models. When we fail them, they feel as though they have few options and certainly no recourse.

Take a stand. Listen to the kids, their parents, their families. And then do something.

Please. 

Where has all the good customer service gone? You might look in Texas

Yes, i know times are changing, blah, blah, blah, but the last several years have left me pining for the days of good customer service. I don't notice a lot of people in outward-facing jobs having much in the way of people skills or the desire to learn them.

A recent trip through the drive-thru of a local fast food restaurant added to my frustration and nostalgia for people who say "thank you" and "have a nice day" when taking my money, coupled with a desire to make things right - to give a customer the type of service she is paying for.

On this particular visit I sat in my car checking my order just after it had been handed to me. I order strangely (I'm a pick eater), so I always double check, especially since this particular place seems to have an aversion to repeating orders back, making correct orders a game of Russian roulette.

The girl in the drive-thru said "there you go" and when I didn't immediately pull forward (there was no one behind me) she asked, "Well, what are you waiting for?" Her tone was snotty and I had to restrain myself from making a rude comment in return. I explained that I was checking my order, aghast that someone would speak to me in such a way after taking my money.

Fast forward to a week or so after that. I had the opportunity to attend the 2011 Sweet Adelines International Convention, hosted in Houston, Texas this year. I'm not sure exactly where the line separating good customer and bad customer service was, but my friends and I experienced nothing but smiles, thank yous and excellent attention to making sure that our experience with whatever business we were patronizing at the time was a mutually pleasant experience. I can't say enough good things about how we were treated in Texas, beginning with the Doubletree in downtown Houston. Everyone, from the valets to the concierge was cordial, attentive and on the spot with whatever we needed.

This was the customer service I have missed for so long. I wanted to scoop all those people up in my purse to bring back home with me in the hopes that some of that goodness would rub off on folks here.

So, there's my customer service rant (and rave). Tell me about your good/bad experiences.

Self-awareness is like a kick in the pants

Tonight I whined on Facebook about not having a BFF. I'm wrong, of course, and I realize that I'm only indulging in a little bit of self-pity, but it's making me wonder about the whys and wherefores of this particular whine.

Some back story here: I have long felt that I've been on the outside of things - looking in on a group from the sidelines, envying their fun and reindeer games, not realizing that all I needed was to just join in. No one else got an engraved invitation, why did I think I needed one? I didn't (and still don't) understand other girls and all the nuances of girlfriend relationships. I don't trust well, never have, and this is a chief reason why I hold back. Who wants to be hurt, you know?

All that said, I really do have a best friend - I married him 11 years ago in October. He "gets" me and it's rare when his words don't soothe my perceived hurts. We have a bond that was immediate when I first met him 29 years ago.

But, I miss him.

My husband is currently studying in an intense pastoral ministry program on top of working full-time and making our house run. He has very broad shoulders and although he would argue with this, withstands the pressure admirably well. Yes, he gripes and whines occasionally about the load he carries, but he would be the first to tell you it's a labor of love for our family.

As the seeds of this post started drifting through my brain, it occurred to me that maybe I am experiencing the feelings he experienced when I was in RN school and working long hours on the weekends. I wasn't home much and when I was, I was studying or writing papers or care plans. There were many times when I would rather have spent time with my family, but it was something I was committed to doing for our family and our goals for the future.

So, how selfish am I when I say I miss him? Very, in my opinion. My whining detracts from the importance of what he's doing for us and for himself and as his wife, it's important that I remember that and support him as much as I can.

Because that's what best friends do.